Possible STI/female kidney pain and fatigue

[Tx78665]

Hi, doc (hoping for HHH),

Long time listener, first time caller.

I’m in an ethnical non-monogamous relationship with my gf. Usually that’s mostly monogamous. We also have unprotected sex with each other.

I’ve had protected sex with other women twice this year. 7 months ago and tested a few months after - clean. And once 8 days ago with unprotected oral and where the condom broke during vaginal.  This was discovered after about an hour of vaginal.

My gf hasn’t been with anyone else this year and has been tested months ago - clean.

After the breakage last week (also had sex with my gf that night oral/vaginal), 5 days later I experienced symptoms (pain at the tip of the penis, itchyness in the groin area) which I believe was genital focused anxiety based on a sti fear (I had a similar experience 2 years ago, no sti after testing back then).  

Around the same time (5 days after breakage) she developed what she described as a pain in her kidney area on the right side and fatigue (she was unaware of my encounter at this point, so not anxiety) with no other symptoms. This has persisted for her, but not for me (once I relaxed some).

She has a history of being disposed to uti’s  and yeast infections but this is presenting differently.

The plan is to follow up with PCPs and get tested, but since you’re the experts:

1. Does the timeline and the symptoms line up with any possible sti infections (I have no visible symptoms).  From previous posts it seems like with this fact set (low partners, testing, no visible male symptoms) that you wouldn’t recommend testing and sti is unlikely, but I’m concerned for her.
2. Is it more likely that the other woman’s microbiome/bacteria/fungus/general virus, etc. was introduced and caused a non sti infection/reaction? Or her reaction isn’t a reaction but coincidence.
3. How long should we wait for PCP follow up and for testing?
4. What should we test for (chlamydia, trich, etc) and what type of test(blood/urine, rapid)?
5. If no common sti’s or other infections could cause her discomfort under these events and the timeframe, should we consider anything else as a cause?

Thank you for your advice.

[auntiejessi]

Unfortunately, we no longer have doctors on our site, so HHH won't be responding. :(

So a couple of things -

First, you can test for gonorrhea and chlamydia now. The timeline for that is 5 days.

Second, it's unlikely that your gf's symptoms are caused by an STD, given that it's so early in the infection. You don't say when you had sex with her after the condom break, but given her history with UTIs, she really needs to get this checked.

Kidney infections are serious, and STDs don't typically cause kidney pain.

That all said, and I don't know what the usual arrangement is for you to share outside encounters, but it would be a good idea to share this one with her so she can let her doctor know, just to rule it out as a cause of her symptoms, though it isn't likely.

Timelines for STD testing -

Gonorrhea, chlamydia and NGU  - 5 days

Mycoplasma - 2 weeks

HIV - 4 weeks using a 4th gen DUO test

Syphilis - 6 weeks - this is uncommon in most developed countries

Herpes  - 12 weeks with a type specific IgG blood test - note that there are a good number of false positives with the hsv2 IgG test, so some opt not to test without symptoms. Unraveling this can take weeks and several hundred dollars.

I think the most important thing is to get your gf to see her doc to rule out a kidney infection or problem.

[Tx78665]

Additionally. Everyone involved is from the US. I’m 47 and both my partners were 43.